Emergency Department RN Case Manager – Weekend Coverage

Stony Brook Medicine; Stony Brook (NY); On-site; USD 93,000 - 132,000; Full time

Job summary

Stony Brook Medicine seeks an RN Case Manager for the Emergency Department to provide clinical case management, utilization management, and care coordination for ED patients. You will evaluate level of care, promote safe transitions, and work with a multidisciplinary team to optimize patient flow.

The role requires strong clinical judgment, knowledge of CMS/payer guidelines, and a commitment to high-quality patient care in a fast-paced ED environment. Weekend and Holiday coverage are required.

Qualifications

• Current New York State Registered Professional Nurse license.
• Bachelor's degree in Nursing or related field.
• Minimum of five (5) years of clinical nursing experience.
• Strong clinical assessment and critical-thinking skills with the ability to evaluate complex patient presentations and determine appropriate level of care.
• Computer proficiency, including Microsoft Office Suite and electronic medical record systems.
• Excellent communication, interpersonal, organizational, and collaboration skills.
• Demonstrated ability to work effectively with physicians, patients, families, and interdisciplinary healthcare teams.
• Strong customer-service skills.
• Ability to prioritize and manage multiple time-sensitive responsibilities within a fast-paced Emergency Department environment.

Responsibilities

• Screen patients presenting to the Emergency Department to determine medical necessity and the most appropriate level and setting of care, including inpatient admission, observation, continued emergency care, or discharge with appropriate services and follow-up.
• Apply MCG criteria in conjunction with clinical judgment, physician documentation, payer requirements, and regulatory guidelines to support level-of-care determinations.
• Collaborate with Emergency Department physicians and the interdisciplinary team regarding patient status, medical necessity, and appropriate disposition; identify cases requiring additional review or escalation when established criteria are not met.
• Perform initial utilization review and assist with payer notification, authorization, and clinical documentation requirements for patients requiring hospitalization or observation services.
• Identify patients who may be safely treated in a lower level or alternative setting of care and collaborate with the healthcare team to facilitate appropriate disposition.
• Conduct timely case management assessments to identify high-risk patients and patients with complex medical, functional, psychosocial, financial, or discharge planning needs.
• Initiate and coordinate discharge planning directly from the Emergency Department, including home care, durable medical equipment, rehabilitation services, skilled nursing placement, transportation, community-based services, outpatient follow-up, and other resources as appropriate.
• Identify barriers that may delay or prevent a safe discharge and collaborate with physicians, Social Work, nursing, patients, families, and community providers to develop an appropriate transition plan.

Skills

Clinical assessment

Critical thinking

Communication

Collaboration

Organization

Prioritization

Customer service

Bilingual

Education

Bachelor's degree in Nursing

Tools

EMR systems

Microsoft Office

Job description

Stony Brook Medicine seeks an RN Case Manager for the Emergency Department to provide clinical case management, utilization management, and care coordination for ED patients. You will evaluate level of care, promote safe transitions, and work with a multidisciplinary team to optimize patient flow.

The role requires strong clinical judgment, knowledge of CMS/payer guidelines, and a commitment to high-quality patient care in a fast-paced ED environment. Weekend and Holiday coverage are required.